Posts Tagged ‘racing thoughts’

I have been quiet over the past month or so. I keep thinking “oh, I really must get around to writing that post”, but it never seems to happen. I do start posts, but somehow they never get finished and by the time I get around to it they have become irrelevant and I end up having to start again. I guess if I started writing shorter posts, it might not take me so long to finish them!

My last proper post (excluding the 2010 review) was pretty negative, but an accurate reflection of my mood at the time. Things have improved a since then, although they still feel a bit shaky. I felt really really awful for a few weeks, but Christmas was bearable and I was able to keep going without slipping any further, so that is encouraging. If that is as low as I get, I can survive, but I don’t know how much lower I could go without ending up back where I was a year or more ago. There were definitely times when I didn’t think I’d make it to here, which was worrying – I’ve not felt like that for a while now, but it has passed now really.

Over the past week I have felt a little on the edge. Motivation has been somewhat lacking and I feel exhausted and low, yet there has been a strange bouncier edge to it too at times. Things don’t feel stable any more. 2010 was a year of relative stability. During summer things were pretty consistent and I felt quite well. Since autumn I’ve been consistently low, but mild depression is manageable. Now I’m all over the place. A few days feeling better, a few days feeling rubbish, one day where I feel all over the place, another where I feel strangely mixed, the occasional day when I just feel normal. There is no consistency at all anymore.

My sleep in particular is a mess. I really struggle to get up each morning and feel exhausted, but then I spend the late evenings trying to slow down my racing and flighty thoughts. I can’t seem to concentrate on any one topic but spend the night with random things darting around my mind. Even when I do sleep, my dreams jump about and I wake up frequently, often shaking or panicky. My dreams have been so weird it has been disturbing me. I find myself thinking about them in the day or unable to shake the uneasy feeling that goes with the nastier ones. Occasionally suicidal thoughts pop up and sometimes these thoughts can be so clear and urgent it can be scary, but there are also excitable flighty thoughts – plans about holidays, knitting, work etc, which would suggest a good mood. It feels slightly strange and can be somewhat frustrating when I can’t sleep, but it is preferable to feeling how I did before Christmas. I quite like the flighty-awake feeling and if I didn’t need the sleep I’d happily become nocturnal and make the most of it, but my body is really tired and I don’t want to keep the bloke and the dog up, so instead I lie in bed tossing and turning.

The last couple of days haven’t been so bad on the mood, but I have been struggling with nausea on and off. I’ve not been sick, but on Sunday night I felt awful. Being sick would have probably been a relief. Nausea does tend to calm down the flighty side of things as moving about just makes me feel worse. Not feeling too bad at the moment, but it seems to come and go.

I am hoping the recent instability can be put down to fiddling with the Reboxetine dose and not taking it consistently at the same time, but I’m not so sure. Things were going haywire before I started the dose experiment. I was told to try taking 8mg some days and 6mg on others to see if it helped with the side effects. I tried it for a bit over Christmas but I found it made the side effects worse than normal on the day I took 8mg and I didn’t feel much respite when taking the lower dose. I’ve also been struggling to get up, so was taking it later than normal, which definitely contributes to the insomnia at the other end of the day. I was trying to take a lower dose on those days, but that didn’t seem to help too much. Things are noticeably worse though if I take the full 8mg dose after about 11am. I’ve gone back to the full dose though and am taking it earlier again, so I hope that will help settle things down.

I saw Dr M on Friday. I mentioned all of this to her. The rapid decline in December, the slight improvement over Christmas and the up-and-downy-ness since. She seemed slightly surprised and a little concerned when I indicated how bad I felt in December, but relieved things have improved a bit since. She thinks I’m a lot stronger these days and that I will be able to manage things better even if I do get more depressed. I think she is probably right.

We discussed medication again. She does think something needs to be added to the Reboxetine. If we can boost the effectiveness of the Reboxetine then maybe I could drop the dose and reduce the impact of the side effects. She’s concerned about sleep too and wants something that will help on that front at the same time. Quetiapine was encouraged again, but I’m still not keen on the idea. It didn’t do anything helpful for me before and I doubt it will again now.

The other option was Mirtazapine. I’m not sure about this either, mainly because of the weight gain risk. I’ve lost a lot of weight over the past year and the last thing I want is to put all of that back on. Aside from that it could probably be a good option. It is meant to be sedating and also partly works on Noradrenaline, which should help. It has a longer half-life than Reboxetine, which could also help stabilise things. I haven’t tried it before so it may be worth a try, especially as it can work when other drugs haven’t, but I’m not sure. I don’t know if it is worth the risk of it not working, although I guess if the side effects are bad I can always discontinue it. I think I’d also be slightly annoyed if it did work because Dr N and I considered it right at the start, but decided against it because of the weight gain risk. Imagine if it is the right drug and we’d chosen it right back then – maybe none of the past 2 years would have happened. Glorious hindsight. I am not sure though and the bloke is definitely not keen on the idea. He thinks I should just try and manage as I am and do what I can to boost the Reboxetine over the winter. Maybe he is right, but then again I don’t want to experience a sudden drop again like in December as if that happens maybe I won’t be able to manage.

I didn’t want to rush into any sudden decision with Dr M anyway, so she said she’d write to Dr N, tell him what she suggests and leave it up to us to make the decision. He can prescribe it if I decide to give it a try. I need to book an appointment to see him and see what he thinks. I think he would be pretty keen to get me off the Reboxetine if we found an alternative that didn’t send me mad, but it’s a risk and I don’t know if it may be better to wait and see.

Friday was also a year since I tried to freeze myself to death whilst overdosing (it sounds ludicrous to me now) landing myself in hospital for 5 weeks. It was weird to see Dr M almost a year on from when we first met and I mentioned this to her. We both commented on how much better things are now. Quite a lot has changed since then and I do wonder if her initial impression of me has changed. I realise now that I was delusional and paranoid at the time we met, as well as being suicidally depressed, but it still upsets me that my behaviour was put down to a disordered personality and not simply the fact I was somewhat mood-disordered and dealing with the after effects of an overdose. I was definitely not myself and I don’t know how anyone could take that first meeting as representative of my usual personality. I am still frustrated by the whole thing and find myself pondering over it again and again. I wonder if now is the time to challenge the whole diagnosis malarkey and find out what she thinks now she has had much longer to get to know me. I wanted to bring it up and I keep considering it, but I’m just too scared. I am terrified of being told they still feel I have a PD. At least before there was always that bit of doubt and a hope they would realise they were wrong. If I bring it up then I may have to face the fact that diagnosis is going to follow me around.

I’m not sure if I ever wrote about this before, but one of the main reasons I want to challenge the diagnosis again has come from the appointment I had with the locum GP a few months ago. When I was there, he looked back through my notes to find something. We were both watching the screen and as he scrolled through I could see that “Personality Disorder – NOS” was filled in the diagnosis box, visible in big bold letters. On some of the entries it didn’t even list “Recurrent Depressive Disorder”, which is meant to be my main diagnosis. In fact it is meant to be my only diagnosis, because I had been told that they wouldn’t give a proper diagnosis of a Personality Disorder unless the psychologist from psychotherapy (when I eventually start it) thinks I warrant it. I had assumed all mention of the dreaded diagnosis would be dropped until then. Apparently not.

So yes, this has concerned me and since then I have toyed with the idea of applying for my notes. I want to see what has been written about me, especially about diagnosis. I have been somewhat paranoid since. I worry about being seen as just another PD and that any physical problems are seen in this light. I worry that Dr N thinks I’m making things up. It has definitely damaged my relationship with Dr N, as I worry that he just sees me through PD disordered lenses and I don’t feel I can trust him as much anymore since finding out he has been using the PD as my diagnosis. I have found it a lot harder to talk to him since then. I have thought about bringing it up since that appointment, but the time passed and I think I missed my chance.

Another opportunity to bring it up may come up soon though. On Saturday I finally got my new assessment appointment date for psychotherapy. It has been nearly 18 months since I was referred. I have an assessment tomorrow with a clinical psychologist, HP. I hope it is less pointless than the last one, but I have no idea what I can say to her. I am worried about bringing up the diagnosis thing. I may just see if it happens. I don’t know what we are going to talk about though. I have no idea what may help or what I need to discuss. In general things are okay and the things that were identified long ago are no longer relevant. It is the more physical sides of depression that get me most these days. I’ve waited so long that I have to see what they can offer though. Maybe it will help in the long term. It may at least help to have somewhere to discuss how I’m feeling about work as I’m trying to get back. I’ve felt a bit on my own in that regard. Fingers crossed it goes okay anyway.

The other thing that Dr M brought up at the end of our appointment, was this blog. She asked if I was still writing. I admitted that I was, although a lot less often than I used to. I said that I keep wanting to write, but don’t often find the time. I go through fits and starts. She seemed to find my response interesting and seemed intrigued. I wondered if she would get curious and want to look at the blog since. I suspect she may have, as someone in the area visited the blog the day after my appointment. I don’t know whereabouts she lives in the area and I guess it could be anyone, but somehow I got a feeling it was her. I’d like to know if she has read it or not though.

So yeah, that was that. I have a lot half-written about work and more to say, but I will leave that for another post. No idea when I will write it though.

So I’ve not been sleeping well the last couple of days. A nasty cold combined with racing and distressing thoughts is tiring me out. I was wide awake last night for hours and hours and no matter how much I tried I didn’t seem to be able to switch off. Eventually my cold must have defeated me and I got a couple of hours of broken sleep, only to wake up to the sound of our dog whimpering and a continuation of the thoughts.

My mind had been fairly still and quiet over the past couple of weeks. My mood was that of low rumbling depression, hidden under a façade of festive cheer. My thoughts have been dark, but calm and slow. It made a change to the agitated depression that had been the main feature of 2009.

It seems though with this cold, my thoughts have quickened. I feel as if I’m in a quiet turmoil, with ever-racing thoughts bubbling under the surface. I start on one thing and it gives me a hundred leads to follow, all in turn leading to more. The thoughts circle and spiral out of control. I can’t get a hold on them.

I store my thoughts up for the night-time, trying to maintain a semblance of normality during the day. Being ill with this cold though has allowed me to stay in bed and I can drop the pretence of normality a little.

I need to untangle everything and write it all down so I can try and make sense of it all, but it would take me hours, days even. I could probably write 10,000 words and still barely scratch the surface. I suspect my bloke may be justified in his complaints if I tried to blog all of that. I’d like the chance to blog some of it though.

I feel so alone with these thoughts though. I don’t know who I would share all this with. I can’t work it all out, let alone express it to others. Some of these thoughts are thoughts I can’t bear to share. Some of these thoughts I desperately want to share, but I am unsure if it is wise. Some of these thoughts are too confusing to know what to do with. I alternate between wanting to share them and thinking it is a very bad idea. Instead they all go round and round in my head and I’m too scared to let them out.

I did actually try and share a few things with Dr N on Thursday, but that has only amplified my confusion. By sharing my thoughts, I have made them real and that has only made them stronger. This just makes it harder for me to tackle the rest.

I don’t really know what to do.

This argument is still rumbling on and I don’t feel strong enough to resist right now. I need time to write, but I feel too guilty for it. The pressure is on for me to get off my laptop and “go and do something useful”, yet I can’t summon the energy for that either. I wish I could hibernate and wait for this to blow over.

I know I’m updating a lot all of a sudden, but I guess there are things I want to document this week. My talkative mood is probably helping too.

I made it to my medical this afternoon. I am so glad it is over.

I was all over the place during the interview. The doctor kept asking the same things over and over again and it was tiresome. My head was spinning, thoughts racing, agitation brewing. I kept forgetting what I had just said and found myself getting more and more worked up. I couldn’t keep still from the agitation. It didn’t help that she wasn’t following things, but I don’t know if that was me talking too fast or her being a bit slow. She kept mixing my doctors up (I know it’s complicated. I still have 2 psychiatrists!) which was getting really confusing.

She didn’t seem to ask me much about what I can and can’t do. She did ask if I got up, dressed etc (yes, with bullying from my bloke). She asked me if I went anywhere (yes, if someone takes me – I mentioned Creative Remedies). She asked me if I saw friends and socialised (sometimes). She asked about driving (no, not since October 2008).

We talked a little about my overdose in February and what happened afterwards. We talked about ECT. I told her when I’d been in hospital. We talked about my current care – The Priory and transfer to NHS, who does what. She asked me a million times if my doctors knew what I was telling her and who was most up to date with everything. I didn’t know why she was asking that so much. Maybe so she knows whether to trust any information she gets from them or so she could check up on what I was saying?

She kept asking me about suicidal thoughts. She wanted to know why I hadn’t tried again if I still experience the thoughts. She asked me literally 30 times if I had any active plans, maybe even more. She seemed quite concerned when I was honest about the extent of my thoughts, even though I have no real means or firm intention to act at the moment.

I was forced to talk about anger and violence. I couldn’t deny that it has been a problem of late, but I didn’t want to be seen as “dangerous”. I felt so uncomfortable talking about it.

We talked about mood. I found it hard to convey what it is really like. I told her about the current agitation and how this is a fairly new development. She suggested the agitation could have been caused by anxiety about the appointment. I didn’t think it was and denied it at the time, but since I’ve thought about it some more I think it may well have contributed. I really was all over the place whilst I was in there and anxiety must have been exacerbating the situation. I tried to describe the aching, dull, flat, numbing depression that has lingered on and off for ages. I tried to describe the mixed agitated depression that is often a problem. I don’t think I succeeded on any account.

I mentioned that my partner had given up his job to care for me and she asked me about this. Is he with me all the time? How often does he leave me on my own? Who does what in the house? Do I ever go out on my own? etc. etc.

When we went over my meds, she seemed surprised that I am taking melatonin and even asked if it’s a hospital-only prescription. Considering melatonin can be bought over the counter in the US, it does make you wonder why it is so reluctantly used over here. The CMHT seemed surprised too.

At one point towards the end, she left the office to go ask her colleague something and I couldn’t help but burst into tears. I’d been holding myself together up until then, but the stress of it all tipped me over the edge. I don’t know what it was as I barely ever cry these days. Girlie hormones probably aren’t helping at the moment, but even still it seemed ludicrous. Unfortunately she came back in whilst I was trying to pull myself together and then asked me a million questions about why I was crying. I was worried she would think I was putting it on for effect or something. I genuinely couldn’t help it, but was so embarrassed and paranoid about it.

Although she asked me a million questions I don’t know if she has got anywhere near enough information. Most of the stuff didn’t seem to be very relevant to whether or not I can work. Maybe she was just nosy? I guess that’s her job.

I cannot convey how erratic the whole appointment was. Questions were being fired in all directions and I was so mixed up I couldn’t answer her. My sentences were blurring into one. I was jabbering on and on and going off on tangents. I didn’t say half the things I should have. I was not clear at all. I’ve been going over things in my head since, trying to make sense of it all. Trying to work out her intentions and what she was thinking and asking. I know I should just forget about it and wait for the results, but my head is just looking for things to think about.

One thing I have noted is the clear effect of stress. I was anxious and stressed by the situation and I could not deal with it at all. I was turned into a whirlwind of agitated confusion. I’m just thinking about work and similar situations where I have to answer questions and think about what I’m saying. Conference calls for example. There is no way I can handle one at the moment. It’s okay doing that with a doctor that is trained to deal with it, but it is not okay to talk like a madwoman in front of your boss.

In some ways my inability to deal with the situation may stand in my favour. I suspect now I probably came across quite mad. After all, I need her to think I am too ill to work. The problem is, I think I may have come across *too* mad. I was incapable of answering her questions and I’m worried I may have messed up in some way. I’m worried I didn’t answer things clearly enough or that I missed things out. I am paranoid that she was trying to catch me out. I’m really worried she will think I was putting it on or making things up. I wasn’t, but I wasn’t “myself” either and that could be problematic.

Afterwards I was tired and didn’t really want to do anything. The session took it out of me and I needed processing time. Kinda like therapy actually. I guess it was similar in that I had to talk a lot about how I was feeling and what has happened.

Unfortunately I wasn’t really given that processing time as my bloke wanted me to do stuff. He forced me to clean my car, which took ages at it was filthy. As I’m not driving at the moment my lovely little car spends most of its time sat on the drive. It has been sat still so long that green slime was growing on all the window seals. Not good. It’s looking better now, but there are still bits that aren’t quite there.

My thoughts are still racing. I walked the dog this evening and I thought that would help calm me down but it hasn’t. I was distracted thinking about the medical, work, suicide, random pointless stuff, everything. I have music spinning around in my head on top of everything else. The “We buy any car” advert is driving me mad… we buy any car, we buy any car, any, any, any, any, we buy any car… Make it stop, please!!

I suspect I won’t be updating quite so much in the next few days. Nothing is happening. We are taking the dog to a breed show on Sunday, but that is all I can think of. I will see Dr N sometime at the end of next week. I have Creative Remedies too, but nothing unusual or exciting coming up.

My mood today has been strange. I woke up this morning with my head racing, thoughts flying all over the place, a preoccupation with work and a desire to do a million things and make a million plans. The verge of hypomania, somewhere I’ve not really been for a while.

The preoccupation with work is strange. I dreamt about going back to work and woke up thinking about all the things I could be doing if I was there. I miss it. I wish I could go back. I have projects I want to get on with.

This speedy mood has been coming and going all day. Concentration coming and going. Thoughts racing.

At Creative Remedies I think I was a little high and probably a little annoying. Talking too much and I was getting bored of my painting too easily. I didn’t know what to do with myself.

Even now I’m jumping from one sentence to another and not even finishing paragraphs.

I wonder where this is going. I’m praying for it to be the end of my depression, yet the rapidly recurrent suicidal thought intruding into the rest of my thoughts suggests it isn’t. It definitely feels like the closest I’ve been to a “good” mood, even if my head feels like it’s spinning too fast, but there is still that dangerous, destructiveness mixed in. I don’t know where I am. I expect this is just rapid cycling showing its head and no doubt it will be gone as suddenly as it arrived, but we will see.

At the moment my mood isn’t physically obvious, but my mind feels like it’s being thrown about and shaken up. I am keeping the agitation down, but I don’t know how long that will last. I am trying to keep myself in check.

Tomorrow I have my ESA medical. I’m worried. I don’t think this mood is going to be helpful. I can’t really think and don’t know how to describe my worst days. I don’t think I seem depressed, which isn’t going to help. I guess I’m there for bipolar disorder, not depression, but it is the depression that stops me working. I don’t even know if I want to have “limited capability for work”. The way I’m thinking at the moment I want to go to work.

It seems I may have entered the land of rapid cycling again. A week of agitated depression has shifted back into plain old depression. I’m still a little agitated and the thoughts are still muddled and racy, but that’s part of the course. My depression is always like that, however I’m no longer jiggling about like a cat on a hot tin roof and full of the energy to act upon the intrusive thoughts.

The shift began yesterday, even before the additional medication was brought into force. Taking the haloperidol pushed things that extra notch. I’m already missing the energy, if not the agitation. I did get some sleep last night, which makes a change but I am tired again. Before, I wasn’t sleeping but I wasn’t really tired either. I had all the energy in the world, albeit not with the concentration to follow my flying ideas though. Now I am left just wanting to hibernate and feeling like crap. I wish I knew where I stood.

I don’t know if to keep taking the haloperidol tonight. I feel I should just follow the psychiatrist’s instructions, but I don’t think she expected me to crash back down quite so quickly. I certainly didn’t expect it to happen so soon. On Thursday, it felt like the agitation was going to last forever and only get worse. Instead, two days later, things are different and I’m really not sure I need to be sedated to the same extent. The extra sleep is a nice change I guess, but I’m not hypomanic anymore, so should I really be taking medication used to control mania?

Considering all of these changes in mood have happened since starting a new mood stabiliser, I wonder just how stabilising this medication is. I know it is early days, but so far I’ve just gone from being constantly suicidally depressed to all over the place. I really don’t know what’s going on. One minute I’m full of beans, albeit with a nasty edge of suicidality and the next I’m lethargic, suicidally depressed but unable to motivate myself to do much of anything. I know I’m safer like this, but it isn’t a nice place to be.

I’ve also started logging my mood again. I had homework from Open CBT to log my activity and stress levels, so whilst doing that it made sense to start logging my mood and agitation too. I was told to a while back and did it at first then kept forgetting. I think it will be helpful to see where the shifts are, but it’s difficult to rate things. When you’re depressed, by nature I think you can be quite negative so I wonder if I am rating things lower than perhaps I should. I don’t know how to rate my mood when I’m always suicidal, even though sometimes my mood may be overall a little higher. How on earth do you show mixed states? Over the past week my presiding mood has been full of the energy of hypomania but with the suicidal side of depression. If I rate my mood negatively (ie as depression) how do I distinguish from the times when I don’t have masses of energy? I don’t know. I guess that’s where the agitation ratings come in. Anyway, I’ve tried to put something together but I’m not sure how useful it really is. I guess I will stick with it for a while, but I probably won’t keep it up like last time. Does anyone else rate their mood and how do you do it?

I last wrote that nothing changes. No sooner than I say that, things seem to be shifting. Things have changed, but I’m not sure that it’s a good thing. Coming off the Depakote and increasing the Lamotrigine appears to have given me loads of energy and is doing something to my mood. Over the past week I have felt this happening and have not known how to stop it and slow things down. I’m now agitated to the point of hypomania, yet still suicidally depressed and I know this is a risky place to be. I’m in the land of agitated depression. My thoughts race, but are largely negative, suicidal and destructive.

My sleep is bad. I think I’m getting a couple of hours at most. At 3.30am last night, I hadn’t slept a wink. I just seem to spend all night tossing and turning, feeling restless and unable to settle with thoughts racing through my head at a million miles an hour.

I’ve ended up seeing Dr G twice this week. I saw her on Tuesday with my partner. This was similar to the last appointment when he came, in that I felt unable to speak and extremely anxious. I become restless and fidgety, which doesn’t help as afterwards my bloke was moaning that I was rude and didn’t seem like I was listening. I was doing my best, but it is hard to follow things when you’re so anxious and your head is doing its best to distract you.

Generally I wasn’t able to be honest with her about how I was feeling and although I mentioned the agitation, I didn’t warn her how destructive I’ve felt. I was quiet and had little to say.

We talked about how I hadn’t heard from the CMHT yet. Dr G said that she still hadn’t spoke to Dr B, but she thinks she knew which psychiatrist it was and she was happy to pass my care onto her. Dr G also said that she hoped to set up a CPA meeting with everyone involved including the CMHT, so we shall see if that ever materialises. She also asked me to give the Allocation team a call to see if they knew what was happening. I did afterwards and it seems I’m being allocated to team this week, so should hear from them soon.

I can’t really remember what else was discussed except the inevitable increase in Lamotrigine. I knew it was coming really.

Yesterday, I saw my GP, Dr N to get my prescriptions and to sort out my sick notes. He was lovely as always and listened to my honest assessment of how things are. He was concerned and tried to get me to promise to use the crisis team if I need it. I just don’t know if I can. My last experience of them was terrible and I just don’t have the self confidence to call them, especially when I’m in a crisis!

Today I had a support group at The Priory and was really agitated and struggling to control the racing thoughts. I managed to be quite honest about how I’ve been feeling, which only caused worry. The therapist, D was doing her best to get me to agree to keep myself safe and to find ways to look after myself. She tried to get me to ask to see Dr G today instead of waiting until next week, but I really didn’t want to do that. She tried to get me to tell my bloke not to go out and leave me alone this evening, but I really didn’t want to do that either.

Following the session, D came over to me and said she’d talked to Dr G. Next thing I knew, Dr G was asking me up to her room. I was able to be more honest with her, although I had to be knowing that the therapist had already filled her in on the basics. I was honest about the agitation and the fact I could feel my mood was shifting. I told her I feel like I’m on the edge and that I don’t know what’s going to happen. I know I can be impulsive when I’m like this and I have all the energy I need to act on these thoughts, something I’ve not had recently. I told her that my partner was out for a few hours this evening and I was scared that I’d take the opportunity whilst it presented itself. Even as I write this, my head is telling me I should be making the most of the opportunity because I might not get another for a while.

Dr G said that she thinks I need medication to help bring things back under control. She wanted me to up the Lamotrigine again and talked about introducing Lithium when I next see her. This change in mood is only making it more obvious that Bipolar is the right diagnosis. She also wanted to give me some short term medication to bring things under control whilst the other meds are titrated up to a therapeutic dose. She wrote me a note for some Diazepam and a few days of Haloperidol. The idea was I’d get a prescription from my doctor this afternoon and then dose myself up so I couldn’t do anything this evening. Unfortunately getting a script today was impossible as Dr N wasn’t working and the stupid receptionist would not agree that it was urgent so wouldn’t push the prescription through as an emergency. Her argument was that the specialist would have given me the medication if she wanted me to start immediately. She wouldn’t listen to the fact that The Priory only issue medication on the ward, don’t have a pharmacy service and didn’t issue me a private script as that would cost me a fortune.

I was glad I got pushed into seeing Dr G as it was a good appointment for once. I was pretty honest and managed to speak up that I needed help. She was concerned, but I think she was pleased that I was able to say something, even if I wasn’t given any choice in the matter by D.

I see her again sometime next week and we’ll discuss the Lithium again. I don’t really know what I think about it. Lithium brings the reality of my diagnosis to the forefront of my mind. I am not too bothered about the blood tests, but I worry about side effects. Mainly I just hope that it works. It’s always been seen as the last option for me and now Dr G is reaching for it. I wonder what happens if it isn’t the drug for me. Do we persevere with the Lamotrigine and hope that can handle things on its own? Do we give up on drugs all together? I don’t know. I guess these are questions for the qualified, questions for the psychiatrist to answer.

Anyway, the evening has come and I’m on my own. I’m trying to keep myself distracted and to keep things under control. I was going to do some painting but I keep staring at my paints and canvases and don’t know what to do.

Instead, I just sit here, unable to stay still and trying to write. I am finding it hard to extract my entry from the muddle of thoughts and words that are in my head, but am doing my best. It is taking longer to write than normal even though everything is going so fast. I think I could stay here rambling for hours, but I am sure it will get boring for everyone and I doubt I’ll make much sense. I’m surprised that what I’ve written so far seems to be half coherent. It doesn’t feel very coherent in my head.

I can feel the agitation on the increase. Things calmed down a bit this afternoon, but I am back up again. I don’t have long left on my own, so I think I can get through it. I hope tonight that I can get some sleep and that things slow down soon, but I don’t know that they will. It only feels that things will get faster and faster at the moment until I fall over the edge or crash into something. Hopefully the medication will settle things down if I can eventually get some tomorrow.

Last week was tough. I went from bad to worse and the end of the week included a visit to my consultant and a review with my key worker. Both events were guaranteed to increase my anxiety and make things worse.

I saw Dr G on Thursday lunchtime. I’d written some notes beforehand as I am fed up the anxiety that ruins every appointment. I arrive at her office and anxiety grabs me around the throat and renders me speechless. My chest is pummelled by fear and I find myself gasping for breath and flailing hopelessly. She speed-read my notes, punctuated with sharp intakes of breath every few sentences. I hate that waiting whilst she is reading my words, reading my mind. I glance around her consulting rooms looking for things to distract myself with. Reading the titles on her bookshelves. Staring out of the window. Avoiding her eyes.

When she’d finished, she turned to me. As always, she took medication first. She upped my Topiramate. 50mg in the morning and 25mg at night now. No surprises there. I had expected my Venlafaxine to finally get the increase she has been promising since November, but still she holds off.

She suggested that suicidal ideation for me has become an almost habitual response to my depression. She suggested that I use it as a coping mechanism, like a pressure valve, that if things are getting too much I begin to think of ways to release it and suicidal thinking gives me that. I don’t know how I feel about her suggestion. To a certain degree she may be right, but I feel she almost trivialises it. I found myself almost wanting to prove to her that I was more serious than that. I know how screwed up that sounds, but I know I’m not exactly thinking straight at the moment anyway. I do wonder when the pressure will push the valve though. One day it might just give.

We talked about work. It seems Dr G thinks I should take a slow approach to returning. Just dip my toe in, by getting in touch with some work colleagues and finding out what’s going on from those on the ground. I guess we’ll see about that. I’m not sure who I’d see. My closest work friends have transferred office or been made voluntarily redundant. I don’t know.

Other than that I can’t remember much. Dr G seemed pretty keen for my one-to-ones to start. She seems to pinning all hopes of recovery on them and thinks they may fill the gaps in my treatment.

After groups on Thursday I saw my keyworker for my review. She had some beck inventories for me to fill in. Both anxiety and depression. I think the anxiety was okay, but my depression scores must have been through the roof. I had no idea what to put on my review form. It asked if you felt worse or better than you did 4 weeks ago. I feel so much worse I cannot describe it. I can’t even remember what it felt like 4 weeks ago. I just know it was better than this.

Friday was more of the same. Therapists seemed concerned about me. They kept asking me if there was anything that had triggered the relapse. If there was anything that had made my mood drop. I don’t know. I don’t really know why I am here again. I just know it isn’t fun. I am frustrated of course. I am always frustrated.

This weekend has been okay though. I have just tried to forget the bad week and try to be normal whilst my bloke is around. It’s not been too bad, although last night I thought my head was going to run away, my thoughts were racing so much. I kept wanting to bash my head against my pillow because it was just driving me so mad. It often happens like that at night. My head feels like it is racing away and I cannot get a hold of it. I lose all concept of size and shape and it just feels so strange.

Tomorrow is another week. A week until I am 23. I cannot believe it is almost my birthday and I am not yet back at work. That is another reason that I feel I have failed. I expected to be back by now. The last thing I expected was to be in this place again. I hate it.

I have to try and see my GP tomorrow. More medication. All I ever do is collect prescriptions and pills. I’m fed up of it.